Comorbid personality disorders and their impact on severe dissociative experiences in Mexican patients with borderline personality disorder

Abstract

Objective: To identify personality disorders comorbid with borderline personality disorder (BPD) that may confer greater risk for the presence of severe dissociative experiences.

Method: Three hundred and one outpatients with a primary diagnosis of BPD were evaluated using the Structured Clinical Interview for DSM-IV Axis II personality disorders, the Borderline Evaluation of Severity Over Time (BEST) and the Dissociative Experiences Scale (DES).

Results: The most frequent personality disorders comorbid to BPD were paranoid (83.2%, n = 263) and depressive (81.3%, n = 257). The mean BEST and DES total score were 43.3 (SD = 11.4, range 15–69) and 28.6 (SD = 19.8, range 0–98), respectively. We categorized the sample into patients with and without severe dissociative experiences (41% were positive). A logistic regression model revealed that Schizotypal, Obsessive-compulsive and Antisocial personality disorders conferred greater risk for the presence of severe dissociative experiences.

Discussion: Our results suggest that a large proportion of patients with BPD present a high rate of severe dissociative experiences and that some clinical factors such as personality comorbidity confer greater risk for severe dissociation, which is related to greater dysfunction and suffering, as well as a worse progression of the BPD.

Keywords:

• Comorbid personality disorders
• dissociation
• borderline personality disorder
• personality disorders
• dissociative experiences

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Andrés Rodríguez-Delgado

Andrés Rodriguez Delgado: Child and adolescent psychiatrist of the Borderline Personality Disorder Clinic at the National Institute of Psychiatry Ramón de la Fuente Muñiz in Mexico City.

Ana Fresán

Ana Fresán: PhD in Psychology and health from the Faculty of Psychology of the National Autonomous University (UNAM). Currently head of the Laboratory of Clinical Epidemiology at the National Institute of Psychiatry Ramón de la Fuente Muñiz. Member of the National Research System (SNI) level III of CONACYT. Her research focuses on stigma, psychopathology assessment and violence.

Edgar Miranda

Edgar Miranda: Clinical psychologist with a Master in Cognitive Behavioral Therapy (CBT). Researcher in Dialectical Behavioral Therapy (DBT) in Borderline Personality Disorder (BPD) and Post Traumatic Stress Disorder (PTSD). Clinical Psychotherapist at the National Institute of Psychiatry Ramón de la Fuente Muñiz in Mexico City.

Eduardo Garza-Villarreal

Eduardo Garza-Villarreal: PhD in Medicine (Neuroscience) from the Center of Functionally Integrative Neuroscience of the University of Aarhus, Denmark. Assistant Professor at the National Laboratory of Magnetic Resonance Imaging (LANIREM), Institute of neurobiology, National Autonomous University of Mexico(UNAM), Querétaro,México. Member of the National Research System (SNI) level I of CONACYT. His work focuses on the study of neuropsychiatric disorders in humans and animal models using neuroimaging.

Ruth Alcalá-Lozano

Ruth Alcalá-Lozano: Psychiatrist with a Master degree in Medical Sciences from the Faculty of Medicine of the National Autonomous University (UNAM) and current PhD student at UNAM. Clinical researcher in the Laboratory of Clinical Epidemiology at the National Institute of Psychiatry Ramón de la Fuent Muñiz.

Xóchitl Duque-Alarcón

Xóchitl Duque-Alarcón: Clincial psychiatrist and PhD in Medical Sciences from the Faculty of Medicine of the National Autonomous University in México (UNAM). Researcher at the Neuropsychiatry Specialty Clinic at the Instituto de Seguridad y Servicio Sociales de los Trabajadores del Estado (ISSSTE) in México City.

Thania Balducci

Thania Balducci: Psychiatrist with a Master degree in Medical Sciences from the Faculty of Medicine of the National Autonomous University of Mexico (UNAM). Current PhD student at UNAM, attending a research residency at the Research Institute for Neurosciences and healthy Ageing at the University of Groningen, Netherlands.

Iván Arango de Montis

Iván Arango de Montis: Clinical Psychiatrist. Master in Medial Science by the National Autonomous University of México (UNAM). Coordinator of the Borderline Personality Disorder Clinic at the National Institute of Psychiatry Ramón de la Fuente Muñiz, México City (INPRF). Member of the National Research System (SNI) level I of CONACYT. His work focuses on the study of development, parenting and psychopathology factors associated with personality disorders.